Salisihan (2024)
What is osteoporosis?
It’s estimated more than 10 million Americans over the age of 50 live with osteoporosis, a bone disease that causes the bones to become weak and brittle.
Osteoporosis, in and of itself, isn’t usually painful. Typically, the condition doesn’t present symptoms until a fracture occurs. “That’s part of the reason it's called a ‘silent disease,’ because it can occur in the background without you knowing it,” says Dr. Nasim A. Chowdhury, chief of rehabilitation medicine at New York Presbyterian Hospital, Queens.
Understanding the risk factors for osteoporosis, making healthy lifestyle choices and curating a solid exercise routine can help you take charge of this common condition.
What is osteoporosis?
Osteoporosis occurs when bone mineral density and bone mass drop significantly, resulting in weaker bones, according to the National Institute of Arthritis and Musculoskeletal Disease.
The hip, spinal cord and wrists are most affected by osteoporosis. However, “unless one were to get tested, you wouldn't necessarily know that your bones are starting to become less dense and less strong,” Chowdhury says. “Oftentimes, we diagnose osteoporosis when someone comes in with a fracture from a fall.” It can be identified from a DEXA scan, a series of X-rays that measure bone density, he notes.
There aren’t usually warning signs of osteoporosis, but noticing back pain or any significant changes to posture should tip you off to see a doctor, says Chowdhury.
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What happens to your body when you have osteoporosis? What causes osteoporosis?
Osteoporosis weakens your bone strength and increases your risk for osteoporotic fractures. “Bone strength is based on the balance of two different kinds of cells: Osteoblasts build bones, and osteoclasts break down bones,” Chowdhury explains. Osteoblasts help form the "scaffolding" of the bones. As mineralization occurs, calcium and other essential minerals fill in this scaffolding, supporting bone density and thickness. Osteoclasts, on the other hand, resorb bone mass.
Hormones (namely, estrogen and testosterone) play an important role in the balance of these processes. In both men and women, these hormones help to increase the activity of osteoblasts. As we age, the rapid decrease of these hormones (estrogen in women, and testosterone in men) impacts bone formation, and accelerates bone breakdown.
Older women are disproportionately affected by osteoporosis; one in four women over the age of 65 live with the condition, according to the U.S. Food & Drug Administration. This is largely attributed to menopause, which causes a steep decline in estrogen levels, Chowdhury says. Women also have a naturally lower bone density than men, which puts them at a greater risk for bone fractures.
Additional risk factors for osteoporosis include: Genetics, being over the age of 50, drinking alcohol, taking certain medications, smoking and not getting enough weight-bearing exercise, per the FDA.
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How to treat, prevent osteoporosis
Treatment for osteoporosis is highly individual. It typically involves a solid exercise regimen, prescription medication and living a healthy lifestyle, says Chowdhury. To manage osteoporosis, a doctor may recommend:
Practicing weight-bearing exercises and strength training. Incorporate weight-bearing exercises like walking, jogging or running into your exercise routine. This should be supplemented with strength training (using weights or a resistance band), which can help stimulate bone formation, Chowdhury emphasizes. You could also try exercises centered around improving balance (such as yoga and tai chi). Working with a doctor or physical therapist can help you curate an exercise plan that’s tailored to your individual health needs. Remember that establishing a regular exercise routine earlier in life (before an osteoporosis diagnosis) is pivotal for preventing bone density loss as you age.
Taking prescription medications. Speak with your doctor about taking prescription medication to help manage your osteoporosis. Bisphosphonates are medications that help slow bone resorption, per the Cleveland Clinic. Other types of medication that could be prescribed to treat osteoporosis include: Parathyroid hormone (PTH) analogs, RANKL inhibitor, sclerostin inhibitors, calcitonin analogs and Selective Estrogen Receptor Modulators (SERMs), according to the FDA.
Making healthy lifestyle decisions. The lifestyle component of osteoporosis treatment cannot be overstated enough, says Chowdhury. Your diet should include foods rich in calcium, the primary mineral component of bones. Having enough vitamin D is also critical for calcium absorption. If you’re not getting enough calcium and vitamin D from your diet, consider taking a supplement (although you should always consult your healthcare provider before taking any kind of supplement), recommends Chowdury. It’s also important to avoid smoking and limit alcohol use.